Consumption trends for specific drugs used to treat dementia in the region of Madrid (Spain) from 2002 to 2012

Neurologia. 2015 Sep;30(7):416-24. doi: 10.1016/j.nrl.2014.02.007. Epub 2014 Apr 4.
[Article in English, Spanish]

Abstract

Introduction: Analysing drug consumption in large population groups lets us observe consumption trends and compare them between different settings.

Objective: to analyse the time trends for consumption and costs of specific drugs used to treat dementia in the region of Madrid (Spain) and compare trends by sex and age cohort.

Methods: Descriptive study of cholinesterase inhibitors (N06DA) and memantine (N06DX01) dispensed in Madrid between 2002 and 2012 and covered by the Spain's national health system. Consumption was calculated by analysing changes in DDD (defined daily doses) to find total and yearly increases. The cost was estimated based on DDD price. To compare consumption rates by age and sex, we calculated DDD per 100 inhabitants/day.

Results: Between 2002 and 2012, consumption of drugs used to treat dementia increased sixfold. During this period, cholinesterase inhibitors accounted for 76.70% of the drugs consumed and memantine, 23.30%. The estimated cost rose by a by a factor of 5.7 over 11 years (or by a factor of 4 taking into account the use of generic drugs). In 2012, 2.42% of the patients aged 65 or over consumed cholinesterase inhibitors (women 2.82%, men 1.83%) and 0.90% consumed memantine (women 1.10%, men 0.61%). Consumption increased in age cohorts up to 86 to 90 (5.84% for cholinesterase inhibitors and 2.33% for memantine) and declined thereafter.

Conclusions: Consumption of cholinesterase inhibitors and memantine gradually increased, but consumption in 2012 did not reach levels equivalent to dementia prevalence figures. Pharmaceutical expenditure restraint measures may temporarily slow the cost increase temporarily but if the same trend of consumption persists, costs will rise.

Keywords: Anticolinesterásicos; Cholinesterase inhibitors; Cost; Coste; Demencia; Dementia; Drug utilization; Farmacoepidemiología; Memantina; Memantine; Pharmacoepidemiology; Uso de fármacos.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cholinesterase Inhibitors / economics
  • Cholinesterase Inhibitors / therapeutic use
  • Dementia / drug therapy*
  • Drug Utilization / economics
  • Drug Utilization / trends*
  • Excitatory Amino Acid Antagonists / economics
  • Excitatory Amino Acid Antagonists / therapeutic use
  • Female
  • Health Expenditures
  • Humans
  • Male
  • Memantine / economics
  • Memantine / therapeutic use
  • Middle Aged
  • Sex Factors
  • Spain

Substances

  • Cholinesterase Inhibitors
  • Excitatory Amino Acid Antagonists
  • Memantine